It’s Not Just an Eye Exam

One can easily be forgiven if they believe an eye examination only determines refractive error (eyeglass prescription or not), whether one has glaucoma, macular degeneration or perhaps ‘dry eye’.  Be informed – due to the eye’s uniqueness, under the trained evaluation of an eye doctor a whole host of health concerns are assessed which may have nothing to do with vision!  When a trained eye doctor looks into your eyes, so much information can be learned. The eyes are literally a clear window to your health and the amount of information they can reveal is astounding.

Many conditions reveal themselves in superficially visible signs on the skin, nails and mouth.  However, the eye is one spot that reveals a particularly large percentage of health issues.  Looking at the eye allows visualization of retinal arterioles and venuoles ‘in vivo’, meaning live and functioning without having to biopsy.  The delicate tissue of the retina can truly be the canary in the coal mine, potentially revealing systemic disorders elsewhere in the body due to both its high metabolic rate and ability to be readily seen with a skilled examiner.  In fact, over 35 different medical conditions can be presented in the eyes alone.  No wonder eye doctors are among the first to asses problems and get the ball rolling for additional medical care. 

I’ve listed some of the top most common disorders which can be diagnosed through ocular examination:

Diabetes – the Center’s for Disease control predicts 40% of Americans will develop this in their lifetime.

Systemic allergies with the ocular surface being often affected.  Oral meds rarely fully treat ocular symptoms.

Autoimmune disorders: (Lupus, sarcoidosis, Bechet’s disease, Sjogren’s disease, myasthenia gravis, multiple sclerosis, Lyme’s disease, HiV, tuberculosis and many others)

Neurological disease or injury: of the 12 cranial (central nervous) nerves, a full four are fully dedicated to the eye (cranial nerve 2, 3, 4, 6) and the 5th or trigeminal nerve has three distributions, one of which is ophthalmic (eye).  In some shape or form, it is said 80% of the brain is utilized in the vision process.  Therefore, an oculo-motor or perceptual deficit is often present in brain disorders or post-injury.

Cardiovascular disorders and Hypertension (elevated blood pressure) often present with obvious signs in vision and ocular health.  Increased cholesterol levels often present as corneal arcus and microscopic ‘Hollenhorst’ plaques viewable in retinal arterioles.  Calcific plaques thrown from the heart are also viewable as are fibrin clots.  These can all have significant visual symptoms if left untreated – including temporary or permanent loss of vision.

Many common medications may have visual and ocular side-effects affecting your ability to focus at near, keep your eye moist and even may permanently affect your delicate retina.  Luckily, signs are often visible during ocular examination which may warn to reduce or stop certain medications if the pro’s outweigh the con’s by the prescriber.

Metabolic disorders and vitamin deficiencies can present in the eyes.  Vitamin A deficiency, Fabry’s disease and Wilson’s disease are a few which come to mind.

Certain cancers and malgnancies are diagnosed by your eye exam.  Melanoma, breast & lung cancers seeding the the eyes, brain tumors in particular and other space-occupying lesions such as pseudotumor-cerebri.

I don’t wont to present a room of horrors to you; rather convince you an annual eye exam is worth more than just you achieving 20/20 vision.  Many health conditions are frequently detected during routine exam.  Many can be treated before becoming more serious.  May I also say an annual eye exam is not a substitute for other medical care, rather a complementary part of the big picture which is your health, vision and normal functioning in this beautiful town of Boulder, Colorado!

 

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